Fentanyl deaths decrease across state, Richmond’s rate remains highest

Read the original article on the Richmond Observer website.

ROCKINGHAM — Richmond County continues to have the state’s highest fentanyl-positive death rate, although the number of such deaths continues to drop statewide.

According to the latest figures published by the Office of the Chief Medical Examiner, the rate of fentanyl-positive deaths in Richmond County from July of 2024 to August of 2025 was 38.1 — more than twice the statewide rate of 14.3.

(NOTE: Rates are per 100,000.)

The OCME no longer lists the actual number of deaths per county, however, the rate is the same as it was for the 12 months ending in July of 2025.

Other counties with the top-1o highest rates are: Bladen (33.6); Gaston (30.6); Burke (30.5); Robeson (29.5); Pasquotank (26.6); Yadkin (26.3); Wilson (25); Buncombe (24.4); and Rowan (22.2).

Statistics show that, statewide, deaths decreased by 17% from 126 in July to 104 in August. Fentanyl-positive deaths are also down 26% compared to the first eight months of 2024, and numbers are the lowest since 2019. 

Neighboring Anson County is one of about a dozen counties with no fentanyl-positive deaths in the past year.

The total number of such deaths peaked in 2022 at 3,358. That year, the county’s rate topped out at 76.7.

Based on reports, fentanyl was the only substance present in 19% of deaths. Over the past year, cocaine has been the largest contributor in polysubstance use fentanyl-positive deaths (36%-53%), followed closely by methamphetamine (22%-41%).

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